【摘要】 目的评价三维适形放疗(3D-CRT)联合化疗治疗Ⅲ期非小细胞肺癌(NSCLC)的临床疗效及并发症。方法分析3D-CRT联合化疗治疗Ⅲ期非小细胞肺癌51例,3D-CRT根据剂量体积直方图给定吸收剂量,总剂量为60～70Gy/8～12次,放疗结束后2周实施化疗,使用诺维本(NVB)30mg/m,第1、8日,顺铂(DDP)20mg/m1～5d,22观察其疗效和并发症。结果51例患者全部完成治疗,无院内死亡。治疗后个月评价近期疗效,1CR14例,PR28例,有效率(CR+PR)为82.4%,不同直径的肿瘤近期疗效不同(=9.73,P<0.05)。随访4～16个月,1年生存率2掊为78.4%(40/51)。不良反应:Ⅰ～Ⅱ级食管炎11例(21.6%),Ⅲ度白细胞减少6例(11.8%),Ⅲ～Ⅳ度外周神经炎2例(4%)。结论3D-CRT治疗肺癌具有明显的剂量分布优势,可显著提高肿瘤的局部控制率,联合NVB+DDP化疗可提高III期NSCLC的治疗效果,而不增加放化疗的并发症。更多还原

【Abstract】 Objective To evaluate the results and complications of 3D conformal radiotherapy followed by chemotherapy for stage Ⅲ non-small cell lung cancer. Methods Fifty-one patients with stage Ⅲ NSCLC received 3D-CRT followed by chemotherapy. According to dose volume histogram, patients received 60 ～ 70Gy in 8 ～ 12 fractions. Chemotherapy consisted of infusion navelbine(NVB; 30 mg/m2/d) on day 1 and 8,and cisplatin (20mg/m2) on day 1 through 5, the results and complications were observed. Results 51 patients all completed the therapeutic regimen as planned, no death happened and reached CR in 14 cases, PR in 28 cases, CR + PR in 82.4%.we also observed that curative effect was different in patient with different size of the tumor(?掊2 = 9.73, P < 0.05). After followed up for 4 ～ 16 month, 1-year survival rates was 78.4%(40/51). In all cases, 11(21.6%) cases had gradeⅠ～Ⅱ radiation esophagitis, 6(11.8%) cases had Neutropenia and 2(4%) had neuritis. Conclusions These data show that 3D-CRT has improved the local control rate because of good dose quality, The following by chemotherapy can improve the curative effect of stage Ⅲ NSCLC without increasing the correlated side effects.更多还原